發(fā)布時(shí)間：2018-05-09 09:17

  本文選題：卵圓孔未閉 + 右心聲學(xué)造影　； 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年16期

【摘要】：目的探討經(jīng)胸超聲心動(dòng)圖(transthoracic echocardiography,TTE)結(jié)合右心聲學(xué)造影在判斷卵圓孔未閉(patent foramen ovale,PFO)右向左分流中的臨床應(yīng)用價(jià)值。方法收集2013年1月至2016年12月在我院心血管內(nèi)科和神經(jīng)內(nèi)科接診的不明原因腦卒中和偏頭痛患者373例(其中腦卒中患者121例,偏頭痛252例),為進(jìn)一步診斷有無(wú)PFO,均接受TTE和右心聲學(xué)造影檢查,其中103例進(jìn)行了經(jīng)食道超聲心動(dòng)圖(transesophageal echocardiography,TEE)檢查。結(jié)果 (1)在靜息狀態(tài)下,373例患者TTE結(jié)果顯示22例合并有PFO;在TTE未檢出PFO的351例患者中,103例患者同時(shí)接受了TEE檢查,結(jié)果顯示49例患者合并PFO。(2)右心聲學(xué)造影檢查結(jié)果顯示:186例患者在Valsalva狀態(tài)和劇烈咳嗽時(shí)存在不同程度的右向右向左分流檢出率為49.87%。其中輕度右向左分流(Ⅰ級(jí))69例;中度分流(Ⅱ級(jí))70例;重度分流(Ⅲ級(jí))47例。(3)TTE檢測(cè)出22例PFO和TEE檢測(cè)出49例PFO患者,右心聲學(xué)造影均顯示中度以上右向左分流。(4)59例TTE結(jié)合右心聲學(xué)造影證實(shí)為中度以上右向左分流且MRI證實(shí)有腦梗塞灶的患者,均在TTE引導(dǎo)下成功進(jìn)行了PFO介入封堵術(shù),術(shù)后1個(gè)月復(fù)查經(jīng)右心聲學(xué)造影顯示,55例在Valsalva和劇烈咳嗽狀態(tài)下右向左分流消失,4例仍有少量右向左分流。結(jié)論 TTE結(jié)合右心聲學(xué)造影不僅能清晰顯示PFO右向左分流的存在,并可判斷右向左分流程度,為PFO的臨床治療提供直接依據(jù);同時(shí)還能作為PFO封堵術(shù)后臨床隨訪的重要工具。
[Abstract]:Objective to evaluate the clinical value of transthoracic echocardiography (TTE) combined with right voice angiography in the diagnosis of right to left shunt of patent foramen ovale (OFQ). Methods from January 2013 to December 2016, 373 patients with unknown causes of stroke and migraine, including 121 patients with cerebral apoplexy, were enrolled in the Department of Cardiovascular Medicine and Department of Neurology in our hospital. All the 252 patients with migraine were examined by TTE and right heart radiography in order to further diagnose PFO.103 of them were examined by transesophageal echocardiography (TEE). Results 1) in the rest state, the TTE results of 373 patients showed that 22 cases were complicated with PFO.103 out of 351 patients without PFO were examined by TEE at the same time in TTE. The results showed that the positive rate of right to left shunt was 49.87 in Valsalva state and severe cough in #number0# patients. The results showed that 49 cases were complicated with PFO.2The results showed that the positive rate of right to left shunt was 49.87%. Mild right to left shunt (grade 鈪，

本文編號(hào)：1865450